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BLEPHARITIS

Blepharitis is an inflammation of the eyelids, which causes the lids to become red and swollen. It is not contagious. Blepharitis can cause to anyone but it is shown to be more prominent in young children and adults over 50 years of age. 

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Symptoms

There are several symptoms of Blepharitis.

These include: 

  • Burning

  • Soreness or stinging in the eyes

  • Crusty eyelashes and itchy eyelids.

  • It can also cause lid cysts (chalazion).

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A gradual onset or chronic history of:

  • Gritty / sore eye

  • Crusting on lashes 

  • Red eyes

  • Red rimmed, thickened lid margins +/- mild to severe crusting on the eyelashes  

  • Blocked or oozing meibomian glands  

  • Red conjunctiva in some

Causes

​The causes for Blepharitis are as follows:

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  • Blepharitis is usually a long-term (chronic) condition, which means once it develops it can cause repeated episodes. 

  • The cause of blepharitis is not known in most cases but, although it is not an infection, it can be caused by a reaction to the bacteria that live naturally on the eyelid skin.

Risk factors

  • Blepharitis is generally not serious, but can produce symptoms that can make wearing contact lenses difficult.            

  • Serious complications, such as sight loss, are rare, particularly if recommended advice is followed.                              

  • Blepharitis has also been linked with dry eye conditions where the eyes do not produce enough tears or dry out quickly.                                                                                                                                                                              

  • Blockage of the glands can lead to chalazion or meibomian gland cyst, leaving a round, painless swelling sometimes with discolouration underneath the eyelid. Most of which disappear within a few months without a treatment.               

  • Much less commonly, blepharitis can lead to changes on the front clear window of the eye (the cornea), which usually require further treatment and a check-up.

Treatment

  • There is no cure for blepharitis, but establishing a daily eyelid-cleaning routine can help control the symptoms.

  • The dryness can be treated with artificial tear drops.

  • Lid cleaning often needs to be continued indefinitely to prevent recurrence.

  • More severe cases of blepharitis may require treatment with antibiotic ointment applied to the eyelids or, antibiotic drops for the eyes and, in a few cases, steroid eye drops.

  • Some patients benefit from oral antibiotics, particularly when the blepharitis is associated with a skin condition such as rosacea.

  • The antibiotic treatments can last between four to six weeks and several months.

CHALAZION

A chalazion is a common condition in which a small lump or cyst develops in your eyelid due to a blocked oil gland. The condition can occur due to inflammation around the opening of the oil glands just behind your eyelashes. This is called blepharitis.

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Symptoms

  • Painless bump or lump in the upper eyelid or, less frequently, in the lower eyelid

  • Tearing and mild irritation may result as the obstructed glands are needed for healthy tears

  • Blurred vision, if the chalazion is large enough to press against the eyeball

  • More common in adults than children; most frequently occurs in people aged 30-50

Causes

  • It is not always possible to identify a cause for a chalazion. However, chalazia are more common in those with blepharitis (eye inflammation) and rosacea.  

  • People with rosacea, characterized by facial redness and swollen bumps under the skin, are prone to have certain eye problems such as blepharitis and chalazia.  

  • Rosacea can affect eyelids, the eye's thin outer membrane (conjunctiva), the clear eye surface (cornea) and the white of the eye (sclera).                     

  • These manifestations of rosacea on the eye collectively are referred to as ocular rosacea.

Treatment

The first stage of treatment involves using a warm compress and massaging your eyelid:

  • Warm compress: Boil some water and let it cool a little or use water from the hot tap. Soak cotton wool or a clean flannel in the warm (but not boiling) water, squeeze it out and gently press onto your closed eyelids for two to three minutes at a time.

  • Massage: Starting at the skin crease, gently massage the upper lid downwards to the lashes. The lower lid should be massaged upwards towards the lashes. This may release the contents of the cyst, which means further treatment will not be necessary.

  • Antibiotics may also be prescribed to reduce the inflammation. If the chalazion does not respond to the first stage of the treatment, it can be drained. Your name will be placed on the minor operation list and you will be given a date to come in for this procedure. Your appointment letter will tell you where to check in on the day of surgery. You will be admitted by the day surgery nurse. The operating nurse or doctor will examine you and discuss the risks and benefits of the surgery and the type of anaesthetic that can be given. They will also ask you to sign a consent form to confirm that you are aware of the risks and benefits and agree to go ahead with the operation.

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